The following questionnaire will help you to decide whether
you should consider seeking help for an eating disorder.

Directions: Answer the questions
below honestly. Respond as you are now, not as the way you
used to be or the way you would like to be. Write the number
of your answer in the space to the left. Do not leave any
questions blank unless instructed to do so.

(Females Only)
My menstrual period has stopped or become irregular
due to no known medical reasons.
| 1 = True | 2 = False |

_____5.

I have become obsessed with food to
the point that I cannot go through a day without worrying
about what I will or will not eat.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____6.

I have lost more than 15% of what
is considered to be a healthy weight for my height
(e.g., female, 5'4" tall loses 20 pounds when a healthy
weight is approximately 122 pounds).
| 1 = True | 2 = False |

_____7.

I would panic if I got on the scale
tomorrow and found that I had gained two pounds.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____8.

I find that I prefer to eat alone
or when I am sure that no one will see me, and thus
make excuses so that I can eat less and less often
with friends or family.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____9.

I find myself going on uncontrollable
eating binges during which I consume large amounts
of food to the point that I feel sick and make myself
vomit.
| 1 = Never | 2 = Less than 1 time/week
| 3 = 1-6 times/week | 4 =
1 or more times/day |

_____10.

(NOTE:
Answer only if your answer to #9 is "1;" otherwise
leave blank.) I find myself compulsively eating
more than I want to while feeling out of control and/or
unaware of what I am doing.
| 1 = Never | 2 = Less than 1 time/week
| 3 = 1-6 times/week | 4 =
1 or more times/day |

_____11.

I use laxatives or diuretics as a
means of weight control.
| 1 = Never | 2 = Less than 1 time/week
| 3 = 1-6 times/week | 4 =
1 or more times/day |

_____12.

I find myself playing games with food
(e.g. cutting it up in tiny pieces, hiding food so
people will think I ate it, chewing it and spitting
it out without swallowing it, keeping hidden stashes
of food) and/or I have determined that there are "safe"
foods that are okay for me to eat and "bad" foods
that are not.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____13.

People around me have become very
interested in what I eat and I find myself getting
angry at them for pushing me to eat more.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____14.

I have felt more depressed and irritable
recently than is typical for me and/or have been spending
an increasing amount of time alone.
| 1 = True | 2 = False |

_____15.

I keep a lot of my fears about food
and eating to myself because I am afraid no one would
understand.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____16.

I enjoy making gourmet and/or high
calorie foods for others as long as I don't have to
eat any myself.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____17.

The most powerful fear in my life
is the fear of gaining weight or becoming fat.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____18.

I exercise a lot (more than 4 times
per week and/or more than 4 hours per week) as a means
of weight control.
| 1 = True | 2 = False |

I tend to be a perfectionist and am
not satisfied with myself unless I do things perfectly.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____21.

I go through long periods of time
without eating (fasting) or eating very little as
a means of weight control.

| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

_____22.

It is important for me to try to be
thinner than all my friends.
| 1 = Often | 2 = Sometimes |
3 = Rarely | 4 = Never |

Scoring:

Step 1: Add your responses together, then write the total
here: __________ This is your score.

Step 2: Compare your score with the table below:

38 or less

Strong tendencies toward anorexia nervosa

39-50

Strong tendencies toward bulimia nervosa

50-60

Weight conscious. May or may not have tendencies
toward an eating disorder. Not likely to have anorexia
or bulimia nervosa. May have tendencies toward compulsive
overeating, obesity, or binge-eating disorder.

Over 60

Extremely unlikely to have anorexia nervosa or
bulimia nervosa. However, scoring over 60 does not
rule out tendencies toward compulsive eating, binge
eating disorder, or obesity.

If you scored below 50, it would be prudent for you to
seek more information about anorexia nervosa and bulimia
nervosa and contact a counselor in the WSC Counseling Center
in order to find out if you have an eating disorder. If
you do, talk with your counselor about what kind of assistance
would be best for you.

If you scored between 50 and 60, it would be a good idea
for you to talk to a counselor in the WSC Counseling Center
in order to find out if you have an eating disorder and,
if you do, how to get some help.

If you scored over 60, but have questions and concerns
about the way you eat and/or your weight, it would be a
good idea for you to talk to a counselor in the WSC Counseling
Center in order to determine if you have an eating disorder
and, if you do, how to get some help.

NOTE: Eating disorders are potentially life-threatening
disorders which can be overcome with the proper information,
support, and counseling. The earlier you seek help, the
better! It is never too late to begin the road to recovery…

The WSC Counseling Center is located in the Student Center,
Room 103. Please make an appointment by calling (402) 375-7321.